新生儿深部真菌病的诊断和治疗:附30例报告

由于广谱抗生素及侵入性医疗操作的广泛应用 ,使深部真菌病 (ｄｅｅｐ ｍｙｃｏｓｉｓ，ＤＭ）的发病率不断增高 ,而且不易诊断 ,治疗困难 ,已成为当代新生儿的重要死因之一。现将１９９３年以来收治的新生儿ＤＭ３０例报告如下。临床资料一、一般资料１９９３年以来因重症新生儿肺炎、败血症住院或抢救１０天以上 ,经多种广谱抗生素治疗无效者。咽或气管内分泌物直接涂片或培养和血培养检出真菌２次以上。确诊条件符合统一标准 ［１］。本组患儿共３０例 ,男２０例 ,女１０例 ,足月儿、早产儿各１５例。原发病 :支气管肺炎２８例 ,败血症２…     

抑郁症患者情绪图片反应特征及杏仁核反应模式的研究

Objective To explore the behavioral and related amygdaiar temporal response to emotional pictures in individuals with major depressive disorder(MDD).Methods Functional magnetic resonance imaging(fMRI)was adopted to examine the neural substrates of emotional pictures processing in 12 first-episode unmedicated MDD subjects(MDD)and 13 healthy controls(HC).Analyses were focused on the temporal dynamics of the blood-oxygen level dependant(BOLD)signal change in the amygdala across blocks of positive,neutral and negative emotional pictures.The crude score to emotional pictures was also recorded.Results(1)The crude score wag(6.6 ±0.2)to positive pictures and(4.7 ±0.1)to neutral pictures in depressed subjects,lower than that in HC(P＜0.01),and(3.4 ±0.3)to negativc pictures in depressed subjects,which was higher than that in HC(2.2±0.2,P＜0.01).(2)The bilateral amygdala showed attenuated and delayed response to the positive pictures.in which the right amygdala showed"group×time"interaction effect to positive pictures(P=0.002).For the negative pictures,there was"group×time"interaction effect in the left amygdala(P=0.008)and group main effect in the right amygdaia(P=0.007),with the attenuated BOLD signal change in MDD group.Conclusions It suggests that amygdala is one of the key neural substrates to the character of the depressed mood or loss of interest in individuals with MDD.Depressed subiects show the attenuated and blunted behavioral and amygdala response to emotional stimuli,which support the hypothesis of the unspecially blunted emotional response in major depressive disorder.     

川芎嗪治疗新生儿硬肿症150例疗效观察

１５０例新生儿硬肿症在一般治疗基础上加用川芎嗪注射液，结果其治愈率为８０％，显著优于对照组，复温时间及硬肿消退时间也显著短于对照组，无明显副反应。     

自尊水平对大学生自我评价的影响研究

目的探讨在不同社会比较类型中,大学生自尊水平与自我评价的关系。方法采用Rosenberg编制的自尊量表,Judge等编制的核心自我评价量表和社会比较后自我评价量表,对重庆4所高校300名大学生进行调查。结果高自尊水平被试的核心自我评价得分明显高于中等自尊水平和低自尊水平被试,不同自尊水平的被试核心自我评价得分差异有统计学意义(F=157.02,P0.01);不同自尊水平的被试在不同社会比较中自我评价得分差异均有统计学意义(F=17.39,32.20,P0.01)。在上行社会比较中,高自尊水平被试自我评价得分明显高于中等自尊水平和低自尊水平被试;在下行社会比较中,高自尊水平被试自我评价得分明显高于中等自尊水平和低自尊水平被试,中等自尊水平被试自我评价得分明显高于低自尊水平被试。结论在社会比较中,自尊水平与自我评价存在正相关,且自尊水平对自我评价具有显著的预测性。     

抑郁症患者情绪图片反应特征及杏仁核反应模式的研究

Objective To explore the behavioral and related amygdaiar temporal response to emotional pictures in individuals with major depressive disorder(MDD).Methods Functional magnetic resonance imaging(fMRI)was adopted to examine the neural substrates of emotional pictures processing in 12 first-episode unmedicated MDD subjects(MDD)and 13 healthy controls(HC).Analyses were focused on the temporal dynamics of the blood-oxygen level dependant(BOLD)signal change in the amygdala across blocks of positive,neutral and negative emotional pictures.The crude score to emotional pictures was also recorded.Results(1)The crude score wag(6.6 ±0.2)to positive pictures and(4.7 ±0.1)to neutral pictures in depressed subjects,lower than that in HC(P＜0.01),and(3.4 ±0.3)to negativc pictures in depressed subjects,which was higher than that in HC(2.2±0.2,P＜0.01).(2)The bilateral amygdala showed attenuated and delayed response to the positive pictures.in which the right amygdala showed"group×time"interaction effect to positive pictures(P=0.002).For the negative pictures,there was"group×time"interaction effect in the left amygdala(P=0.008)and group main effect in the right amygdaia(P=0.007),with the attenuated BOLD signal change in MDD group.Conclusions It suggests that amygdala is one of the key neural substrates to the character of the depressed mood or loss of interest in individuals with MDD.Depressed subiects show the attenuated and blunted behavioral and amygdala response to emotional stimuli,which support the hypothesis of the unspecially blunted emotional response in major depressive disorder.     

脑电联合同步功能MRI在局灶性癫痫检测中的应用价值

目的探讨脑电监测模式的脑电同步功能MR成像（EEG-fMRI）技术在局灶性癫痫患者间期痫样放电引起的脑区激活情况的应用价值。方法对12例局灶性癫痫患者进行EEG-fMRI数据采集；以间期痫样放电的事件相关设计模式对fMRI数据进行分析，观察癫痫放电引起脑激活的时空分布情况。并与MR结构成像病灶定位结果进行对比。结果12例患者中，共采集到10例患者的18次有效EEG-fMRI数据。与结构病灶相对比，11次数据显示定位结果较好，5次结果尚可，2次结果不佳；其中6例患者2次采集的定位结果相同。18次扫描结果均显示激活大脑对侧的小脑有稳定的激活；10次结果中丘脑有正激活信号，9次有位于典型的缺省状态分布脑区的负激活信号。结论EEG-fMRI技术利用多模态神经成像技术的优点，在癫痫的研究方面有较大的应用价值。     

抑郁症患者情绪图片反应特征及杏仁核反应模式的研究

Objective To explore the behavioral and related amygdaiar temporal response to emotional pictures in individuals with major depressive disorder(MDD).Methods Functional magnetic resonance imaging(fMRI)was adopted to examine the neural substrates of emotional pictures processing in 12 first-episode unmedicated MDD subjects(MDD)and 13 healthy controls(HC).Analyses were focused on the temporal dynamics of the blood-oxygen level dependant(BOLD)signal change in the amygdala across blocks of positive,neutral and negative emotional pictures.The crude score to emotional pictures was also recorded.Results(1)The crude score wag(6.6 ±0.2)to positive pictures and(4.7 ±0.1)to neutral pictures in depressed subjects,lower than that in HC(P＜0.01),and(3.4 ±0.3)to negativc pictures in depressed subjects,which was higher than that in HC(2.2±0.2,P＜0.01).(2)The bilateral amygdala showed attenuated and delayed response to the positive pictures.in which the right amygdala showed"group×time"interaction effect to positive pictures(P=0.002).For the negative pictures,there was"group×time"interaction effect in the left amygdala(P=0.008)and group main effect in the right amygdaia(P=0.007),with the attenuated BOLD signal change in MDD group.Conclusions It suggests that amygdala is one of the key neural substrates to the character of the depressed mood or loss of interest in individuals with MDD.Depressed subiects show the attenuated and blunted behavioral and amygdala response to emotional stimuli,which support the hypothesis of the unspecially blunted emotional response in major depressive disorder.     

低频振幅算法功能磁共振成像对双侧海马硬化颞叶癫痫的研究

目的 采用静息功能磁共振成像低频振幅(ALFF)技术,探讨颞叶癫痫脑活动的神经机制.方法 采用功能磁共振成像技术,观察伴有双侧海马硬化(HS)的内侧颞叶癫痫(mTLE)患者脑血氧水平依赖信号活动的改变.对南京军区南京总医院20例伴有HS的mTLE患者及20名正常志愿者进行静息态数据采集,并计算出各受试者ALFF值;采用两样本t检验,以P＜0.01水平观察TLE患者相对正常人,ALFF增高及降低的区域.结果 相比正常人,TLE患者BOLD信号ALFF改变的区域呈双侧对称分布.ALFF升高区域以边缘叶为中心进行分布:包括双侧海马旁回、杏仁核、脑干网状结构区、下丘脑、部分扣带回等边缘系统;双侧感觉运动区、枕叶、颞下回及眶额回等新皮层区;以及中脑腹侧及小脑内侧等皮层下结构,以右中央前回(15,-12,51)为最大ALFF增高区(T=6.02).ALFF幅度降低的区域包括:扣带回前部、内侧前额叶及楔前叶等经典缺省模式区域,双背外侧前额叶及颞上回,双豆状核头部、中脑背侧结构及小脑后叶等结构,以小脑(3,-78,-21)为最大ALFF降低区(T=-4.42).结论 ALFF功能磁共振成像技术可以对癫痫引起的脑活动改变情况进行观察.ALFF增高的脑区反映了大脑对癫痫活动的产生、传播等易化作用,边缘叶在TLE中起着重要作用;ALFF降低区域反映了大脑对癫痫活动的抑制,尤其是缺省模式功能的受抑制.